Update #84

Big things continue...

First, Dave was successfully transferred out of the ICU to the "normal" hospital, Room #1108, at 4:30 yesterday afternoon, and he is doing great. The first night went well - sleep (both of ours) was interrupted every few hours from coughing fits (Dave's not mine) as Dave continues to clear the fluid out of his lungs, but overall, it has been a good transition. His room is wonderful compared to Bed #15 of SCC2 - it has its own bathroom (not that he uses it), a beautiful view of downtown Knoxville (which he can't see since it sits on the right side of his bed) and a door instead of a curtain. Okay, so the room is probably more of a step up for his parents and me than it is for him as far as amenities are concerned, but it is much quieter and much more private, so we all appreciate that. We have uninterrupted visiting hours, and so far, the nurses and doctors have been just as responsive and wonderful as they were downstairs, so the "scary" of the move seems to have passed. When we ask Dave if he likes his new room, he just shrugs - I guess one hospital room is the same as the next for him, although he did mention that he likes the fact that I actually have somewhere to sleep now (that blue plastic chair in SCC2 where I was "watching him sleep" every night - not sleeping myself, since that would be against the rules, and I would NEVER do anything to break the rules (sarcasm, in case you didn't catch it) - was getting a little uncomfortable). Overall, Non-ICU Day #1 has been a success.

Second, I almost typed that Dave is getting settled nicely in his new room, but today has brought to light the fact that "settled" is not, in fact, the goal. Dr. Taylor, Dave's doctor who met him the first night and performed the majority of his surgeries, came by this morning to check on him and was grinning at how well he is doing. Right off the bat, she confirmed that the drainage from his colon does need to stop completely before the plastic surgeon can do the skin graft, which we expected. When I asked, however, how soon we would be able to move him after the skin graft is in place, we got an answer we did not expect - once she has seen that Dave is doing well out of the ICU for a few days, she sees no reason why he shouldn't be moved out of UT altogether, onto his next phase of recovery, without his final surgery completed. From her perspective, patients improve dramatically once they are out of the hospital (even if Dave would be moving to another hospital of sorts), and because it could be another month before the drainage stops, moving Dave soon might be the best thing for him.

This piece of news has started a whirlwind of events and information that have kept us spinning for the rest of the day. To make a very long story short, papers are being submitted to the Drake Center in Cincinnati and St. Mary's Select Specialty Hospital here in Knoxville to determine if Dave, in his current condition, qualifies for a transfer to either (or both) (SIDENOTE FOR ALL THE MICHIGANDERS: A transfer to Michigan was considered, but the Select Specialty Hospital in Pontiac did not seem to be as well suited to Dave's needs as the options in Ohio and Tennessee). Once we have confirmation that he qualifies, it will be out of UT and onto one of the two new treatment centers.

Aside from the fact that the speed at which this has all happened (they are saying he could be moved next week) is completely overwhelming, the pros and cons to both locations seem to be endless. In the end, however, this is where we are:

1. A move to the Drake Center means that Dave will be closer to family and friends at a well respected facility with a wide variety of services that will meet his needs from now through his entire recovery, including outpatient rehab. It also means a long transport (probably five hours by ambulance) or an expensive one (air ambulance), both of which may not be covered by insurance and may be very hard on Dave;

2. A move to St. Mary's means that Dave has a very short trip to a well respected facility and will remain close to his doctors (including his current plastic surgeon) for any needs that he may have in the future (including his skin graft). On the flipside, he will remain farther from friends and family and will need to be moved again for rehab once his wound is healed.

The only conclusion that we have reached as of now is that there is no easy answer. From Dave's perspective, Cincinnati is very appealing, but not if he has to spend five hours on a stretcher in the back of an ambulance. For the moment, we are waiting on word from Drake and St. Mary's as to whether or not Dave can be admitted to their facilities in his current condition. In the meantime, the Client Services person at UT is researching the possibility of getting Dave's transport to Cincinnati (by ambulance or, preferably, by plane) paid for by his insurance.

Over the next day or two, as more information comes in, please be praying for wisdom on this huge decision. In the end, we want what is best for Dave, whether that is UT, St. Mary's, Drake, or someplace else that God has yet to show us (because I feel the need to complicate my thinking further). We are trying very hard to weigh all of the options, but this whole process has come about so quickly that I think we are really hoping to have time to take a deep breath before any decision needs to be made.

One other prayer request: this afternoon, one of the residents came in to cap Dave's trach so that he can begin breathing out of his nose and mouth again instead of out of his neck (the cap will also allow him to talk normally). The process includes removing the current tube that is down his throat and replacing it with another type of tube, but when the doctor tried to remove the current tube, it got stuck. The whole process made Dave pretty nauseated, and in the end, he stayed on the trach collar and continues breathing out of his neck. The doctors will try again tomorrow - be praying that the current tube loosens up and comes out without a problem so that Dave can be one step closer to breathing completely normally again.

I hope nobody is too overwhelmed - we'll keep you posted as we get more news. As always, His Spirit, His will, His peace, His glory...no matter what the next few days may hold.